Cutaneous Metastasis from Hepatocellular Carcinoma Mimicking Pyogenic Granuloma / 대한피부과학회지

Skin lesions can sometimes be the presenting sign of metastatic cancers. We report a case of skin metastasis resembling pyogenic granuloma from hepatocellular carcinoma, which is a common malignancy in Korea. A 79-year-old male presented with a 1 month history of a dark-reddish nodule on his left cheek, which was thought to be pyogenic granuloma. On histopathologic examination, it was composed of tumor cells and intervening sinusoids and therefore showed characteristics of hepatocellular carcinoma. We confirmed hepatocellular carcinoma upon abdomen computer tomography. We present this case along with a review of previous reports of cutaneous metastasis from hepatocellular carcinoma.

A Case of Signet-ring Cell Gastric Carcinoma of which the First Symptom was Skin Lesions / 대한피부과학회지

Cutaneous metastases of internal malignancies are rare and the incidence of metastatic skin lesions as the first symptom of disease is only 0.8% in patients of all malignancies. Furthermore, cutaneous metastasis from adenocarcinoma of the stomach has been found to be exceedingly rare. A 39-year-old woman presented with multiple, asymptomatic, erythematous nodules on her scalp and back. A biopsy taken from the nodule showed a signet ring cell type of adenocarcinoma. A gastroendoscopic examination and biopsy was done and showed the same histologic findings. The diagnosis of cutaneous metastasis of signet-ring cell gastric carcinoma was made. It is clinically worth reporting that the first symptom was skin lesions of the scalp and back.

The Change of the Frontal Hair Line According to the Treatment for Androgenetic Alopecia / 대한피부과학회지

BACKGROUND: Androgenetic alopecia (AGA) occurs as a result of progressive miniaturization of scalp hair in genetically predisposed individuals. Several effective treatments for AGA are well known. However, there is a paucity of literature about the influence of such treatments on the frontal hair line (FHL). OBJECTIVE: To assess the effectiveness of oral finasteride and/or topical minoxidil on the FHL. METHODS: An assessment of 100 male patients with AGA of grades II to IV was made, based on the Norwood- Hamilton scale after six months of treatment. The patients were divided into three groups. Group 1 received 1 mg of oral finasteride daily. Group 2 exclusively used 5% minoxidil solution 1 ml twice daily. Group 3 received 1 mg of finasteride daily in combination with a topical application of 5% minoxidil solution. We measured the length from the mid-pupillary line to three points of the FHL with calipers; midpoint of the forehead, and right and left temporal recession, respectively. RESULTS: An improvement of the FHL was observed in all of three groups. There was a tendency for patients taking only finasteride to show an overall improvement in the frontal hair line, while patients applying only minoxidil solution showed an improvement in both temporal recession lines. Comparing the three groups at three points of the FHL respectively, at both temporal recession of the FHL, Group 3 showed the best result, followed by Group 2, and finally Group 1. The center of the FHL Group 3 showed the best result, followed by Group 1, and finally Group 2. CONCLUSION: We found that the combination therapy of finasteride and minoxidil had a synergic effect on FHL in the treatment of androgenetic alopecia. In the assessment of treatment efficacy to the FHL of patients with AGA, the method of using calipers in this study was worthwhile.

A Case of Giant Basal Cell Carcinoma / 대한피부과학회지

Basal cell carcinoma (BCC) represents the most common cutaneous malignancy in caucasions. Most of the tumors usually occur on sun-exposed skin, and they are small and easily treated. Giant BCC is a rare variant of this tumor and is defined as a lesion greater than 5 cm at its largest diameter. For the development of giant BCC, several risk factors, including patient neglect, aggressive histological features and long duration, have been identified. We observed a very large BCC on the face and scalp of an elderly woman. She had been reclusive for a long time, and this problem might have played a crucial role in the development of the giant BCC.

Introduction to the Electronic Textbook for Cutaneous Diseases

The diagnosis of cutaneous disorders depends mainly on the visual observation of skin lesions. To make accurate diagnoses, extensive experience with a number of different pathological states is required. An atlas that contains a wide range of pictures of cutaneous disorders is one way to gain indirect experience. However, the textbooks usually used for this purpose are inappropriate. With recent developments in computer science, which have made it possible to show many pictures relatively easily, a number of electronic textbooks have been published in medicine, especially in Western countries. However, most of these texts are simply modifications of earlier textbooks, and consist of text descriptions with a few added pictures, a practice that does not make the most of the benefits an electronic textbook can offer. In Korea, the Korean Dermatological Association as well as individual dermatologists have published several textbooks, including the 'Atlas of Skin Disease'. However, there has been no attempt to make an electronic textbook containing numerous images of cutaneous diseases with their descriptions. In 1986, we began to compile an electronic textbook for cutaneous diseases and completed it under the name the 'eBook of Dermatology', in 2004. It consists of 29 chapters, covering 1,116 diseases. Twenty-three dermatologists participated in collecting the 4,028 pictures, and writing the descriptions, which are given in the following form for each disorder: definition, cause and pathogenesis, clinical manifestations, pathologic features, diagnosis and differential diagnosis, and treatment.